Property claim form - Household cover
NFRN Member No
Is your business VAT registered (Commercial claims only)
Fields marked * are required.
Details of Event
Date of Event
Time of event
Where did the event occur?
Is any Third Party to blame for the loss or damage? If so, give name and address
Brief Description of loss or damage
Claims for loss by BURGLARY, THEFT or MALICIOUS DAMAGE
Method of Entry
The extent to which the premises/items were protected from loss or damage at the time of the occurrence, eg.alarm, cctv, locks, or any other security
Have Police been notified? If so, give station, date and crime reference if known.
Details of Loss
Loss of property
Description of property for which loss is claimed
Serial No's of items
Current Replacement Cost
Value of salvage
Date of purchase or acquisition
Amount of loss or damage claimed
Damage to property
Description of property and scope of damage
Name of repairer
Cost of repairs
(1) Tax Invoices for repairs or replacement must be posted to us.
(2) Where an item of equipment must be replaced, and you propose to replace that item with:
- The same brand of equipment, but a different model; or
- A different brand of equipment You must indicate whether the replacement equipment is the equivalent of, or better or more extensive than, the equipment it is replacing.
being a Member and on behalf of the Member declare the above answers to be true and correct and acknowledge that NFRN Mutual may make its decision to exercise discretion to grant protection having regard to these answers.
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